HomeMy WebLinkAbout1972-08-31 Permit, Sewer & Water Hookup #3281Village Permit
Contractor Address____��
Owner Address
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State License No. Village License No
Parcel No.
Section No —
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Bloch_ Subdivision
Date
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install plumbing systems: Fee $
Install
,ewage disposal systems: Fee $ _
Repair
Install �
water s y syk ^Fee $ r' C
Repair -�
i n t Fee $—
Total amount paid to Village....... $
Signature of applicant
Signature of Village Official /